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Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation.

Publication ,  Journal Article
Estrella, JS; Rashid, A; Fleming, JB; Katz, MH; Lee, JE; Wolf, RA; Varadhachary, GR; Pisters, PWT; Abdalla, EK; Vauthey, J-N; Wang, H; Wang, H ...
Published in: Cancer
January 1, 2012

BACKGROUND: Neoadjuvant chemoradiation before surgery is an emerging treatment modality for pancreatic ductal adenocarcinoma (PDAC). However, analysis of prognostic factors is limited for patients with PDAC treated with neoadjuvant chemoradiation and pancreaticoduodenectomy (PD). METHODS: The study population was comprised of 240 consecutive patients with PDAC who received neoadjuvant chemoradiation and PD and was compared with 60 patients who had no neoadjuvant therapy between 1999 and 2007. Clinicopathologic features were correlated with disease-free survival (DFS) and overall survival (OS). RESULTS: Among the 240 treated patients, the 1-year and 3-year DFS rates were 52% and 32%, with a median DFS of 15.1 months. The 1-year and 3-year OS rates were 95% and 47%, with a median OS of 33.5 months. By univariate analysis, DFS was associated with age, post-therapy tumor stage (ypT), lymph node status (ypN), number of positive lymph nodes, and American Joint Committee on Cancer (AJCC) stage, whereas OS was associated with intraoperative blood loss, margin status, ypT, ypN, number of positive lymph nodes, and AJCC stage. By multivariate analysis, DFS was independently associated with age, number of positive lymph nodes, and AJCC stage, and OS was independently associated with differentiation, margin status, number of positive lymph nodes, and AJCC stage. In addition, the treated patients had better OS and lower frequency of lymph node metastasis than those who had no neoadjuvant therapy. CONCLUSIONS: In patients with PDAC who received neoadjuvant chemoradiation and subsequent PD, post-therapy pathologic AJCC stage and number of positive lymph nodes are independent prognostic factors.

Duke Scholars

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

January 1, 2012

Volume

118

Issue

1

Start / End Page

268 / 277

Location

United States

Related Subject Headings

  • Radiotherapy, Adjuvant
  • Prognosis
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Estrella, J. S., Rashid, A., Fleming, J. B., Katz, M. H., Lee, J. E., Wolf, R. A., … Abbruzzese, J. L. (2012). Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation. Cancer, 118(1), 268–277. https://doi.org/10.1002/cncr.26243
Estrella, Jeannelyn S., Asif Rashid, Jason B. Fleming, Matthew H. Katz, Jeffrey E. Lee, Robert A. Wolf, Gauri R. Varadhachary, et al. “Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation.Cancer 118, no. 1 (January 1, 2012): 268–77. https://doi.org/10.1002/cncr.26243.
Estrella JS, Rashid A, Fleming JB, Katz MH, Lee JE, Wolf RA, et al. Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation. Cancer. 2012 Jan 1;118(1):268–77.
Estrella, Jeannelyn S., et al. “Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation.Cancer, vol. 118, no. 1, Jan. 2012, pp. 268–77. Pubmed, doi:10.1002/cncr.26243.
Estrella JS, Rashid A, Fleming JB, Katz MH, Lee JE, Wolf RA, Varadhachary GR, Pisters PWT, Abdalla EK, Vauthey J-N, Wang H, Gomez HF, Evans DB, Abbruzzese JL. Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation. Cancer. 2012 Jan 1;118(1):268–277.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

January 1, 2012

Volume

118

Issue

1

Start / End Page

268 / 277

Location

United States

Related Subject Headings

  • Radiotherapy, Adjuvant
  • Prognosis
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Humans